Potentially controversial plans to change the way some frontline hospital services are delivered in west Wales are set to be announced today.

Bronglais hospital campaigners took their fight to the steps of the Senedd

Controversial plans to change the way some frontline hospital services are delivered in West Wales are emerging.

Prince Philip Hospital in Llanelli is to see its accident and emergency department become a 'local accident centre' staffed by nurses. The hospital will still have emergency care provision.

Mynydd Mawr, Tregaron and Aberaeron hospitals are to close with services provided elsewhere.

Minor injuries services are to be entirely nurse-led, either in GP practices or one of the four main hospitals, Withybush, Bronglais, Prince Philip and Glangwili.

The minor injuries services at Tenby are to be delivered from GP practices with staff redeployed to Withybush.

The health board wants to reduce hospital admissions by providing 24-hour community care. GP appointments are to be made available from 8am to 9pm Monday to Friday and 9am to 1pm at weekends.

It is to invest £40m in a five-year programme to build community resources across the area where health and social care professionals will be based.

The proposed changes are now up for consultation for 12 weeks.

All of the nation’s seven health boards are in the process of drawing up plans for the reconfiguration of services across Wales, which the Welsh Government say will help improve patient care, and today Hywel Dda Health Board will reveal its.

Reasons behind reform were outlined as part of the Welsh Government’s Together For Health document published in November.

The Welsh Government maintain change is needed to tackle inequalities in health, increasing numbers of patients with chronic conditions, medical staffing pressures and some specialist services being spread too thinly.

However, plans to centralise some services have been met with strong criticism, with Health Minister Lesley Griffiths strongly denying accusations of downgrading some district hospitals.

In the Together for Health document, Ms Griffiths pledged no district general hospitals would close but said patients may have to travel further for specialist care in centres of excellence.

Campaigners in west Wales have been protesting heavily against potential changes being made to some district hospitals by Hywel Dda, including Bronglais Hospital in Aberystwyth and Prince Phillip Hospital in Llanelli.

Dr William Roberts, spokesman for the Save Bronglais Hospital campaign group, said: “We want to ensure that Bronglais Hospital is a viable entity in Mid Wales by securing things like surgical services, including A&E, orthopaedics and chemotherapy.

“We want to see health provision in Mid Wales both in hospital and the community equal to the south. I think there is a feeling in the community of despair and anguish and many people are feeling abused.”

In May, campaigners delivered one of the biggest petitions received by the Welsh Assembly’s petitions committee, calling for Hywel Dda Health Board to retain a major A&E unit at Prince Phillip Hospital after options were put forward to turn it into an “urgent care centre”.

The BMA said decisions to change services should be made in the interests of patient safety.

At their annual conference, a motion was unanimously passed calling on the Welsh Government to take responsibility for the reconfiguration of health services rather than heath boards.

John Jenkins, the British Medical Association Wales’ senior public affairs officer, said: “Any reconfiguration must be evidence-based, ensure patient safety and be a needs-based service, not a response-based service.

“We would like to see a Welsh national strategy covering the whole of Wales as changes to one health board area could impact on services in a neighbouring area.”

However, a Welsh Government spokeswoman said: “The Welsh Government takes full responsibility for the reconfiguration of services although it is important the process is led by the health boards themselves.”

As part of reconfiguration plans, senior children’s doctors could be located to specialist inpatient centres rather than general units.

In an essay featured in the Western Mail today (Monday - Health Wales), Dr Iolo Doull, the Royal College of Paediatrics and Child Health’s Officer for Wales, supported the arguments for change but said it was important the right decisions were made.

He said: “Closure and changes to children’s services instil fear among parents and it is completely understandable that parents are worried about their local services moving away.

“Children need specialist care and equipment so reconfiguration of some services will mean that children may need to travel a little further but they will receive a higher standard of care from the right doctors, using the best equipment, at the right place and at the right time.

“It’s not something that can be done quickly, but it’s one that if done properly will deliver the best standard of healthcare for children.”

Hywel Dda Health Board chairman Chris Martin said: “We look forward to launching our formal consultation and hope to show our local population how we intend to provide a world class health service now and in the future.

“The formal launch of the 12-week consultation follows extensive discussion with our clinicians, over two years, and an unprecedented listening and engagement exercise, held earlier this year with local people, staff and stakeholders.

“We have reflected on these discussions and refined and shaped our proposals in light of what we heard. The proposals we will present will demonstrate that any new or changed services are fit for purpose and for the future, person-centred, high quality, modern, safe and affordable. We would like to thank everyone who was involved in the listening and engagement exercise and urge them to maintain this enthusiasm and passion for the NHS and take part in our consultation.”

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